Abstract
This Research Letter estimates weekly hours worked for married, dual-physician couples.
Among physicians, women are more likely to work part time than men, and female physicians with children spend more time on parenting and domestic tasks. Little is known about how physicians within dual-physician couples adjust hours worked due to children or whether sex differences, if they exist, have changed over time, especially because physicians of both sexes have increasingly emphasized the importance of shared parenting responsibility.
Methods
We estimated weekly hours worked for married, dual-physician couples from January 2000 to December 2015 using the American Community Survey, a nationally representative, United States Census Bureau–administered survey of approximately 3 million households annually. The survey is collected by mail, telephone, and personal-visit interviews. Response rates range between 90% and 98%. The Harvard institutional review board waived study review.
We included individuals whose self-reported occupation and that of their spouse were both physician or surgeon. Specialty was unavailable. We limited analyses to physicians age 25 to 50 years to focus on childbearing years. We excluded couples with children younger than 1 year as hours reported may reflect hours worked immediately after the child was born. Same-sex couples were excluded because of our focus on sex differences within couples.
We estimated a multivariable linear regression of weekly hours worked as a function of age of youngest child (categorical variable), ages of each spouse, races of each spouse, state, and time period. We estimated separate regressions for male and female physicians and computed adjusted hours worked by age of youngest child, holding other covariates at their mean values. We also examined trends in hours worked from 2000 to 2015 by physician sex and presence of children, adjusting for the characteristics above. Stata version 14.2 (StataCorp) was used for statistical analyses.
Results
Our sample included 9868 physicians (4934 men and 4934 women in dual-physician couples). For men, mean age was 39.3 years and 37.6% were nonwhite; for women, mean age was 38.1 years and 40.1% were nonwhite (Table 1). Among couples without children, adjusted weekly hours worked were 57.0 hours for men and 52.4 hours for women (Table 2). Compared with couples without children, there was no statistically significant difference in adjusted hours worked among men whose youngest child was age 1 to 2 years (55.3 hours; difference, −1.7 hours; 95% CI, −3.6 to 0.3) but hours worked were significantly lower among women (41.5 hours; difference, −10.9 hours; 95% CI, −13.1 to −8.8). Among men, there was no significant difference in hours worked as age of youngest child increased compared with men without children. Among women, hours worked remained statistically lower compared to women without children as age of youngest child increased (Table 2). Older physician age was associated with fewer hours worked (data not shown). Among both male and female physicians, differences in hours worked between physicians without children and those with children were similar across the study period (data not shown).
Table 1. Characteristics of Dual-Physician Couples in American Community Survey, 2000-2015.
| Characteristic | Mean (95% CI) | |||||
|---|---|---|---|---|---|---|
| Full Sample (n = 4934 couples) | Couples Without Children (n = 1194) | Couples With Youngest Child Age 1 to 2 Years (n = 1171) | Couples With Youngest Child Age 3 to 4 Years (n = 677) | Couples With Youngest Child Age 5 to 6 Years (n = 506) | Couples With Youngest Child 7 Years or Older (n = 1386) | |
| Male physicians | ||||||
| Hours worked | 55.7 (55.2-56.1) | 60.7 (59.7-61.7) | 55.0 (54.2-55.9) | 53.5 (52.3-54.6) | 53.5 (52.3-54.8) | 53.2 (52.5-53.9) |
| Age, y | 39.3 (39.2-39.5) | 34.0 (33.7-34.4) | 37.2 (37.0-37.5) | 39.7 (39.3-40.0) | 41.5 (41.2-41.8) | 45.3 (45.1-45.4) |
| Nonwhite, % | 37.6 (36.2-38.9) | 42.0 (39.1-44.8) | 37.9 (35.1-40.7) | 38.3 (34.7-42.0) | 38.3 (34.1-42.6) | 32.3 (29.9-34.8) |
| Female physicians | ||||||
| Hours worked | 44.6 (44.0-45.1) | 58.3 (57.1-59.4) | 41.9 (40.7-43.0) | 38.1 (36.8-39.5) | 38.6 (37.2-40.1) | 39.0 (38.1-40.0) |
| Age, y | 38.1 (37.9-38.2) | 32.6 (32.3-32.9) | 35.6 (35.4-35.9) | 38.2 (38.0-38.5) | 40.3 (40.0-40.6) | 44.5 (44.3-44.7) |
| Nonwhite, % | 40.1 (38.7-41.5) | 44.3 (41.5-47.1) | 41.2 (38.4-44.1) | 40.4 (36.7-44.1) | 38.4 (34.1-42.6) | 35.6 (33.1-38.1) |
Table 2. Adjusted Hours Worked Per Week by Age of Youngest Child for Male and Female Physicians in Dual-Physician Couples, 2000 to 2015a.
| Age of Youngest Child | (95% CI) | |||
|---|---|---|---|---|
| Male (n = 4934) | Difference | Female (n = 4934) | Difference | |
| No children (n = 1194) | 57.0 (55.4-58.5) | 1 [Reference] | 52.4 (50.7-54.1) | 1 [Reference] |
| Age 1 to 2 y (n = 1171) | 55.3 (54.0-56.6) | −1.7 (−3.6 to 0.3) | 41.5 (39.9-43.0) | −10.9 (−13.1 to −8.8) |
| Age 3 to 4 y (n = 677) | 54.8 (53.0-56.6) | −2.1 (−4.7 to 0.4) | 40.0 (38.2-41.7) | −12.4 (−15.0 to −9.8) |
| Age 5 to 6 y (n = 506) | 55.4 (53.7-57.1) | −1.6 (−4.0 to 0.9) | 41.3 (39.5-43.2) | −11.0 (−13.8 to −8.3) |
| Age ≥7 y (n = 1386) | 55.2 (53.9-56.5) | −1.7 (−4.1 to 0.6) | 43.2 (41.4-44.9) | −9.2 (−12.1 to −6.3) |
Table based on author calculations using data from the US Census American Community Survey from 2000 to 2015. Results are from a multivariable regression model of hours worked as a function of age of the youngest child (no children, age 1-2, 3-4, 5-6, and ≥7 y), ages of spouses (25-29, 30-34, 35-39, 40-44, 45-50 y), races of spouses (non-Hispanic white, non-Hispanic black, Hispanic, other), time period (2000-2005, 2006-2010, 2011-2015), and state fixed effects. Table reports adjusted hours worked according to age of youngest child. Separate regressions were estimated for male and female physicians. The US Census Bureau provided race and ethnicity categories on the survey; responses to race and ethnicity questions are based on self-identification.
Discussion
In a national sample of dual-physician couples, weekly hours worked by women with children were lower than among women without children, whereas similar differences were not observed among men. Differences within sex in how physicians’ work hours respond to children did not narrow between 2000 and 2015. One possible reason for our results is that even within dual-physician couples, societal expectations for women to reduce hours worked to care for children still hold. Alternatively, women in certain specialties may be more likely to both work fewer hours and have children, which would confound our analysis due to our inability to adjust for physician specialty. In addition to lacking physician specialty information, this study used cross-sectional, rather than longitudinal, data.
References
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